We report a case of keratoacanthoma in a non-sun-exposed nasal vestibule of an 84-year-old man. He presented with a progressively growing left nasal mass that had been present for 8 months. Examination showed a non-tender protruding mass arising from medial vestibular wall of the left nostril. Histopathology indicated it was a keratoacanthoma. In an elderly patient with a history of a progressively growing mass in the nose, a differential diagnosis of malignancy should be ruled out, and histological conformation is essential. To our knowledge, only a very small number of cases of nasal vestibular keratoacanthoma have been reported.
Embryonal rhabdomyosarcoma of external ear canal is very rare, even in the pediatric population. We report an embryonal rhabdomyosarcoma of external acoustic canal, occurring in a 12-year-old Chinese girl who presented with left ear canal mass. Wide local excision of the mass was done under local anesthesia. Histopathological examination revealed the diagnosis. She then underwent 20 cycles of radiotherapy. CECT scan post treatment showed clearance of tumor cell. Now, patient is disease free for 5 years. We believe that early diagnosis followed by complete resection of the tumor with clear margin and radiotherapy improves the prognosis of the disease.
Ethylmalonic encephalopathy is a rare metabolic disease presenting in infancy with developmental delay, acrocyanosis, petechiae, chronic diarrhea and early death. The biochemical characteristics of this autosomal recessive disease are urinary organic acid abnormalities. Recently it has been found to be caused by mutations in the ETHE1 gene, located on Ch19q13. Only about 30 patients have been reported, and we describe two additional cases. The first patient showed a typical clinical picture and biochemical abnormalities, with additional atypical clinical features. Neuroimaging studies showed extensive changes. A new homozygous mutation in exon 3 of the ETHE1 gene was found. The second patient was not investigated genetically; however besides the typical clinical picture and biochemical profile he was found to have cytochrome C oxidase deficiency.
Dye-Sensitized Solar Cells (DSSCs) have attracted great attention due to environmentally friendly low-cost processing, excellent working ability in diffuse light, and potential to meet the power demands of future buildings due the true class of building integrated photovoltaics (BIPV). Nevertheless, DSSCs have relatively low photoconversion efficiency (PCE) due to multiple issues. Several strategies have been employed to enhance its PCE. For instance, bi-layered structure of photoelectrode i.e., mesoporous TiO2 transparent layer with top scattering layer was introduced which scatter light inside on large angles improves the harvesting ability of photoelectrode thus enhanced PCE. However, scattering layer is composed of aggregated small particles which offer sluggish electron transport due to multiple grain boundaries, consequently, unwanted recombination reaction which leads to poor PCE. This issue has been addressed for transparent layer immensely but ignored for scattering layer. Mostly for scattering layer in previous studies novel structures have been proposed to enhance scattering properties and dye adsorption only. Therefore, in this study for the first time presenting dual functional graphene/TiO2 scattering layer in which solvent exfoliated graphene is incorporated in TiO2 submicron spheres which enhanced electron transport properties, while submicron spheres scatter light effectively. Scattering and electron transport characteristics of DSSCs are thoroughly investigated with the function of graphene loading. Electrochemical impedance spectroscopy (EIS) has revealed that diffusion coefficient length and coefficient and conductivity attained maximum value at 0.01 wt%. while other important parameters such as electron lifetime and electron density in conduction band have been improved till 0.020 wt% graphene loading. However, results indicated that with 0.01 w% graphene 33% higher PCE was achieved than without scattering layer and 13% higher than scattering layer without graphene. The depraving in PCE at >0.01 wt% graphene despite of excellent electron transport improvement is attributed to the loss of diffuse reflectance and higher optical absorption by graphene.
Synovial sarcoma is a rare soft tissue sarcoma of the head and neck region involving the parapharyngeal space. The diagnosis of synovial sarcoma can be very challenging to the pathologists. We present a rare case of parapharyngeal synovial sarcoma in a young female patient who had a two-month history of left cervical intumescent mass at level II. The fine needle aspiration cytology of the mass was proved inconclusive. Transcervical excision of the mass was performed and the first case of parapharyngeal sarcoma was identified in our center by fluorescence in situ hybridization (FISH) technique. Repeat imaging revealed residual tumor. The patient successfully underwent a second excision of the residual tumor and received adjuvant radiotherapy.
Cat scratch disease (CSD) is a benign condition caused by the inoculation of Bartonella henselae. The imaging findings are non-specific, and it is difficult to diagnose the disease via imaging. However, imaging studies help exclude other differential diagnoses in diagnostic dilemmas. We encountered a case of a 17-year-old adolescent who presented with painful neck swelling. CT showed multiple bilateral cervical lymphadenopathies with triangular soft tissue mass at the anterior mediastinum likely to be thymic hyperplasia, which is unusual in CSD and was mistaken for a lymphoproliferative disorder. Tissue diagnosis with a thorough clinical history yielded the diagnosis of cat scratch disease, and follow-up imaging showed resolution of the cervical lymphadenopathy and thymic hyperplasia.
Tinnitus is a common disorder, it can be classified as pulsatile and non-pulsatile or objective and subjective. Pulsatile tinnitus is less common than non-pulsatile and can be due to vascular tumour such as glomus or vascular abnormality. We presented an interesting case of a 30 year-old Malay lady with a two-year history of pulsatile tinnitus which was worsening in three months duration. It was associated with intermittent headache. Clinical examination and tuning fork test were unremarkable. Apart from mild hearing loss at high frequency on the left ear, the pure tone audiogram (PTA) was otherwise normal. In view of the patient's young age with no risk factor for high frequency loss, a magnetic resonance imaging (MRI) was performed to look for any abnormality in the cerebellopontine angle. It revealed a single vessel looping around the left vestibulocochlear and facial nerves at the cisternal portion, likely a branch of the anteroinferior cerebellar artery (AICA). Literature review on the pathophysiology and treatment option in this condition is discussed.
Large Vestibular Aqueduct Syndrome (LVAS) is the most common radiographic malformation in children with early onset of hearing loss. Usually its occurrence is non-familial, however intriguingly a portion of patients with LVAS is found to have evidence of genetic predisposition. We described cases of LVAS in two siblings of a Chinese family. The elder sister first presented with reduced hearing since childhood and her brother has a similar complaint upon further questioning. Their hearing test showed bilateral sensorineural hearing loss (SNHL) and computed tomography (CT) of temporal bone showed enlarged vestibular aqueduct in both patients. We described an approach to diagnosis of LVAS and highlight the importance of hearing assessment in genetic link hearing loss.
The inherent toxicity, mutagenicity and carcinogenicity of dyes that are discharged into aquatic ecosystems, harming the health of humans and animals. ZIF-8 based composites are regarded as good adsorbents for the breakdown of dyes in order to remove or degrade them. In the course of this research, metal-organic framework materials known as ZIF-8 and its two stable composites, ZIF-8/BiCoO3 (MZBC) and ZIF-8/BiYO3 (MZBY), were produced via a hydrothermal process and solvothermal process, respectively, for the dangerous Congo red (CR) dye removal from the solution in water using adsorption method. According to the findings, the most significant amount of CR dye that could be adsorbed is onto MZBC, followed by MZBY and ZIF-8. The pseudo-second-order kinetic model was used effectively to match the data for adsorption behavior and was confirmed using the Langmuir isotherm equation. There is a possibility that the pH and amount of adsorbent might influence the adsorption behavior of the adsorbents. According to the experiment results, the technique featured an endothermic adsorption reaction that spontaneously occurred. The higher adsorption capability of MZBC is because of the large surface area. This results in strong interactions between the functional groups on the surface of MZBC and CR dye molecules. In addition to the electrostatic connection between functional group Zn-O-H on the surface of ZIF-8 in MZBC and the -NH2 or SO3 functional group areas in CR molecules, it also includes the strong π-π interaction of biphenyl rings.
Forest clearing for agriculture plantations and local community settlements may trigger food insecurity, which causes poor development, predominantly in Orang Asli children. This cross-sectional study was conducted to determine the relationships between food security and anthropometric and cognitive function among Orang Asli children in Temerloh, Pahang. Materials and methods:A total of one hundred and sixty-seven children (ages 7 to 11) from five selected Orang Asli villages (Kampung Sungai Enggang, Kampung Penderas, Kampung Pasu, Kampung Lubok Wong, and Kampung Pian) were involved in this study. The food security index was assessed using the Radimer/Cornell Hunger and Food Insecurity Instrument. Anthropometric indices were based on height-for-age and BMI-for-age Z-scores, while cognitive performance was tested using Raven’s Coloured Progressive Matrices (R-CPM). Results:A majority (91.6%) of the respondents reported some kind of food insecurity (12.6% household food insecure, 74.2% individual food insecure, and 4.8% child hunger). Rates of stunting, thinness, and overweight/obesity were 25.8%, 16.2%, and 18.0%, respectively. A majority (46.1%) of the children had average cognitive scores, followed by below average (38.3%) and above average (15.6%), respectively. Height-for-age was significantly associated with cognitive function (p=0.008). Among sociodemographic factors, household size (p=0.007) and household income (p
This cross-sectional study aims to determine the provision of foods according to NOVA classifications (an ultra-processed classification), to assess contribution of sodium and added sugar availability in each of NOVA food groups, and to evaluate nutritional status as well as to determine the relationship between sodium, added sugar availability of each NOVA foods groups and nutritional status among adults in Terengganu. Materials and methods:About 200 respondents aged between 18 and 59 years old from Kuala Nerus, Terengganu were recruited. Their dietary intake from two days of 24-hour dietary recall underwent NOVA classification and analyzed through Nutritionist Pro. All respondents had their blood pressure and fasting blood glucose taken. Spearman’s rank correlation was used to evaluate the relationship between sodium and added sugar each of NOVA food groups and the nutritional status. Results:The total energy intake of the respondents was 1818 kcal +375.05 per day. The energy contribution of ultra-processed group was 24%. The sodium and added sugar contribution of ultra-processed group were 26% and 63%, respectively. The mean blood pressure and median of blood glucose were normal at 114/79 mmHg and 5.3 mmol/L, respectively. No significant correlation was found between sodium, added sugar availability of each NOVA food groups and nutritional status at p
In managing patient with congenital congenital aural atresia (CAA), preoperative high resolution computed tomography (HRCT) scan and hearing assessment are important. A grading system based on HRCT findings was first introduced by Jahrsdoefer in order to select appropriate candidates for operation and to predict the postoperative hearing outcome in CAA patients. The score of eight and more was considered as a good prognostic factor for hearing reconstruction surgery. However previously in our center this score was not used as the criteria for surgical procedure. This study was conducted at Center A to evaluate the correlation between pre and postoperative hearing level with HRCT based on a Jahrsdoefer grading system in patients with CAA. All records and HRCT films with CAA from January 1997 until December 2007 at Center A were evaluated. The demographic data, operative records, pre and post operative hearing levels and HRCT findings were analyzed. Hearing level in this study was based on a pure tone average of air-bone gap at 500 Hz, 1 kHz and 2 kHz or hearing level obtained from auditory brainstem response eudiometry. This study was approved by Research Ethics Committee (code number, FF-197-2008). Thirty-two ears were retrospectively evaluated. The postoperative hearing level of 30 dB and less was considered as successful hearing result postoperatively. Of the six ears which underwent canalplasty, three had achieved successful hearing result. However, there was no significant correlation between preoperative hearing level (HL) with HRCT score and postoperative HL with HRCT score at 0.05 significant levels (correlation coefficient = -0.292, P = 0.105 and correlation coefficient = -0.127, P = 0.810) respectively. Hearing evaluation and HRCT temporal bone are two independent evaluations for the patients with CAA before going for hearing reconstructive surgery.
Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.
Neuropathy is frequently a late complication of diabetes mellitus. Auditory neuropathy and microangiopathy of inner ear are the possible causes of hearing loss in diabetics. To study the correlation between glycaemic control and hearing threshold in patients with type 2 diabetes mellitus and to determine the differences of hearing threshold between groups treated with different modality. This single blind randomized controlled study was performed at the Department of Medicine and Department of Otorhinolaryngology, Hospital Universiti Kebangsaan Malaysia (UKM) between 1st May 2003 and 31st September 2004. This study was approved by Research Ethics Committee (code number FF-137). Subjects were randomized into two groups. Group 1 were patients treated with conventional oral hypoglycemic agents. The patients in group 2 were those treated with insulin injection. The subjects were seen 4 weekly for 3 months. Audiometric test were performed in all subjects at each visit. Blood were taken for fasting blood glucose, Hb1Ac, and fructosamine at every visit to determine the glycaemic controls of the subject. They were 11 patients (22 ears) treated with oral hypoglycemic agents and 17 patients treated (34 ears) with subcutaneous insulin. There is no significant difference between mean pure tone threshold before and after treatment at all frequencies in both groups. There is also no significance different in fasting glucose level and fructosamine. However, there is significant difference HbA1c levels between the two groups after treatment (P
Introduction: The aim of this study was to determine the effects of pedometer-based intervention and the relationship between daily walking steps and nutritional status among overweight/obese university students in Kuala Terengganu. Materials and methods: The study was an 8-week intervention study that included 23 overweight/obese university students. After 7 days of baseline activity, anthropometric data such as weight, height and waist circumference and a one-day dietary record were taken. The participants were divided into a control and case group. The control group (n=15) was instructed to continue with their normal activities and habits throughout the 8 weeks. The case group (n=8) was instructed to walk based on the targeted number of steps. Data such as body weight, waist circumference and a one-day dietary record were taken after the intervention. Results: Both case and control group show significant differences in body mass index (BMI) with p=0.017 and p=0.047 respectively. However, there is a large and significant difference between walking steps and BMI before and after intervention for the case group. There were no differences in any other study parameters during the 8-week study. Conclusion: In conclusion, short-term intervention with a pedometer increased physical activity and positively affected the BMI of overweight/obese participants. The use of a pedometer was efficient in measuring daily physical activity (r= 0.756, p< 0.05).
Burn injuries are one of the most devastating injuries in the world. A uniform burn wound is essential for burn research. The objective of this study was to describe a new model for inducing deep partial-thickness burns in rats. Burn wounds were performed on the dorsal part of Sprague-Dawley rats using a constructed heating device in our laboratory. Digital images of each animal were captured every day for macroscopic evaluation and for assessment of the wound contraction rate. Six animals were sacrificed on days 1, 3, 7, 11, 14, and 21 after onset of burn and their skin tissues were harvested for histological analysis. Uniform deep partial-thickness burns could be achieved in Sprague-Dawley rats under the condition of a contact temperature of 70°C, with the weight of heating devices of 300 g, and a duration of 10 s. Macroscopic evaluation recorded the general appearance of the deep partial-thickness burns. Evaluation of the wound contraction rate showed that the deep partial-thickness wound area was reduced by 90.39% of the original wound area by day 21 after burn. Microscopic evaluation by hematoxylin-eosin staining revealed the histological changes during the wound healing process. This is a standardized and reproducible model for inducing deep partial-thickness burns in Sprague-Dawley rats.
This study was aimed to see the difference between chondrocytes from normal cartilage compared to chondrocytes from microtic cartilage. Specific attentions were to characterize the growth of chondrocytes in terms of cell morphology, growth profile and RT-PCR analysis.
This study was aimed at regenerating autologous elastic cartilage for future use in pediatric ear reconstruction surgery. Specific attentions were to characterize pediatric auricular chondrocyte growth in a combination culture medium and to assess the possibility of elastic cartilage regeneration using human fibrin.
Introduction: The aim of this study was to assess the overall diet quality of husbands and wives in a selected urban area in Selangor.
Methodology: This cross-sectional study was carried out in Bandar Baru Bangi, Selangor among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not practicing any special diet. Data were collected using a 2-day 24-Hour Dietary Recall and a Food Frequency Questionnaire (FFQ) to evaluate the quality of diet among husbands and wives using the Diet Quality Index Revised (DQI-R).
Result: Majority of husbands and wives in this study were in the middle-age group, had received tertiary education, had household monthly income of more than RM3, 500 and encompass household size of 3 to 5 persons. The mean DQI-R score for husbands (mean age= 43.33 + 11.16 years) and wives (mean age= 41.28 + 10.93 years) were 67.8 + 9.1 and 64.4 + 9.3 respectively and there was a significant different in scores between the husbands and wives (p < 0.001). In general, the diet quality of this study population was not satisfactory and that the diet quality of husbands was better compared to their wives.
Conclusion: This study gives an insight picture of husbands and wives’ quality of diet. It can be used as a guideline to improve health intervention programs in the future.